GPs SHOULD BE IN HOSPITALS

GENERAL practice is in real trouble — with a perfect storm of soaring demand, cuts in funding, staff shortages and ever more red tape.

No wonder patients struggle to get appointments. No wonder GPs feel disillusioned, their jobs no longer seen as fulfilling, leading in turn to difficulty recruiting and retaining them.

Part of the problem lies with the independent subcontractor status of GPs south of the Border, an historic arrangement dating from the start of the NHS in 1948. It means GPs are effectively small businesses ‘hired in’ by the health service. But this model is no longer fit for purpose: a recent survey revealed only one GP in five sees partnership as the most attractive career option. General practice is losing 100 partners a month.

One of my friends, an experienced GP in her late 40s, is typical. She recently resigned from her partnership and is happily working as a locum. A single mother of two teenage boys, she has more freedom, less administrative burden and is able to concentrate on patient care. What she misses is being able to provide continuity of care, which we all acknowledge improves outcomes and is more satisfying for both patient and doctor.

But the cavalry is riding to the rescue: a West Midlands hospital trust has announced it’s taking over 18 practices covering 100,000 patients, with the GP partners giving up their independent status to become salaried employees.

This will enable them to concentrate on care and relinquish the burden of management. It also has the potential to reduce the divide between general practice and hospital care.

Patients and medical staff alike can only benefit when GPs are able to work alongside their specialist colleagues, ideally participating in the care of their patients when they’re in hospital, with access to hospital record systems and the ability to freely investigate their patients using hospital facilities.

It’s time the walls came down: I hope we see more such schemes soon.